During many surgical procedures, a region of tissue such as an organ is cut or resected by the operating physician. In order to more fully expose a cutting or resection plane, it is known to retract or pull apart the cut tissue. For instance, one or more stay sutures may be secured to the tissue and the sutures may be pulled taught to open or expose the deepening resection plane. As one illustrative example, one known method of performing hepatic parenchymal transaction utilizes polypropylene stay sutures to expose the deepening transaction plane.
The details of this operative technique are disclosed in Aloia et al., Two-Surgeon Technique for Hepatic Parenchymal Transection of the Noncirrhotic Liver Using Saline-Linked Cautery and Ultrasonic Detection, Annals of Surgery, Vol. 242, No. 2, August 2005. As described in this publication, two surgeons are required to transect the liver. A first surgeon located on one side of the patient uses an ultrasonic dissection device to dissect the tissue. A second surgeon located on the other side of the patient uses a saline-linked cautery device to coagulate and divide dissected vessels. In addition, to expose the deepening transaction plane, the surgeons manually apply traction on the stay sutures to separate the cut tissue.
While the two-surgeon operative technique provides advantages over prior techniques, the technique requires two surgeons to perform the operation. It would be preferable if a single surgeon could perform the transaction operation. Unfortunately, using the technique disclosed in Aloia et al., a single surgeon cannot dissect and/or coagulate the transected tissue while at the same time applying the necessary traction to the stay sutures to expose the deepening transaction plane.
Surgical retractor devices are also known that eliminate the need for a surgeon (or other person) to manually apply tension to a portion of cut tissue. For example, U.S. Pat. No. 4,274,398 issued to Scott discloses a surgical retractor which includes a frame conformed to fit the surface contour of the portion of the body to be operated on. The frame has a plurality of notches spaced about its periphery. The device further includes a number of elastic stays with hooks that are used to retract the tissue. The elastic portion of the stays is adapted to be inserted into one of the notches and is held in place by friction to retract the tissue.
The retraction device disclosed in Scott, however, is unsuitable for laparoscopic applications. Instead, the device disclosed in Scott includes an annular frame that is conformed to fit the surface contour of the exterior portion of the body to be operated on. In addition, the retractor disclosed in Scott utilizes elastic members to retract tissue. Because of this, as the tissue is cut at deeper and deeper depths, some slack builds in the elastic tensioning members. To increase the biasing force, the surgeon must manually adjust the tensioning member by repositioning the elastic member the same or a different notch.
There thus is a need for a surgical retractor that is capable of applying a substantially constant biasing force to a portion of tissue without needing to manually readjust the tensioning members. Moreover, the surgical retractor could advantageously be deployed within a body cavity, for example, in laparoscopic applications. For instance, the surgical retractor could enable a single surgeon to perform tissue transection procedures.